However, there were more cases of minor bleeding in cangrelor patients, reported Deepak L. Bhatt, MD, MPH, of Brigham and Women's Hospital in Boston, and colleagues, in a letter in the Journal of the American College of Cardiology.

As reported in the original results, mild bleeding was markedly more common in the cangrelor population (14.9% versus 10.5%, P<0.001). With the new analysis, however, this cohort also had more thrombolysis in myocardial infarction (TIMI) minor bleeding (0.6% versus 0.2%, P<0.001).

This "suggests that minor bleeding may be more likely to be under-reported with lack of adjudication, whereas major bleeding and transfusions seem to be adequately captured regardless of adjudication," the authors wrote.

"The computer algorithm used in CHAMPION PHOENIX to determine bleeding events did not account for data not reconciled properly," they added, pointing to instances in which data were not correctly recorded on case report forms.

The revisited analysis was not immune to limitations either as "observation bias could not be excluded as the adjudication was unblinded," the authors noted.

In January, watchdog group Public Citizen wrote a letter to Veterans Affairs denouncing the trial for allowing "inappropriate and shocking delays in antiplatelet therapy for subjects enrolled in the control group."

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